Cutaneous metastasis of tonsillar carcinoma: Report of a rare case

Ramser, Amy; Craig, Elise M.; Delost, Gregory R.; Baron, Elma D.

doi:10.1016/j.jdcr.2018.03.003

Cited by 2 publications

(8 citation statements)

References 8 publications

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“…Only 5 cases of tonsil SCC metastatic to the skin have been described previously. [7][8][9][10][11] The first case was reported in 2002. 7 A 40-year-old man with a history of chronic smoking presented to a head and neck cancer clinic with a 3-month history of painful swallowing and bilateral neck swelling for 1 month.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, only 5 previous cases have been described. [7][8][9][10][11] Owing to the exceptional occurrence of metastasis from tonsil SCC to the skin, this condition may be misdiagnosed, leading to delayed treatment and worse prognosis for the patients. Therefore, metastatic tonsil SCC should be considered in the differential diagnosis of malignant basaloid neoplasms of the skin.…”

Section: Introductionmentioning

confidence: 99%

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Metastatic Tonsil Squamous Cell Carcinoma: An Important Consideration in the Differential Diagnosis of Malignant Basaloid Neoplasms in the Skin: Case Report and Review of the Literature

Thigpen,

Johnston,

Giubellino

et al. 2024

The American Journal of Dermatopathology

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Malignant basaloid neoplasms of the skin are frequent, and their accurate diagnosis holds paramount importance for treatment and prognosis. However, these neoplasms can present diagnostic challenges because of their extensive differential diagnosis, which encompasses cutaneous metastasis among many other possibilities. We present a case of a 74-year-old man with a history of p16-positive palatine tonsil squamous cell carcinoma (SCC) treated with surgery and adjuvant radiation with no prior evidence of recurrence who presented to the dermatologist with 2 chin papules. The initial histopathologic evaluation of these lesions showed poorly differentiated malignant basaloid neoplasms. Subsequently, these biopsies were compared with the previous biopsies from his tonsil and lymph node, which showed similar findings including positive p16 staining and positive molecular testing for human papillomavirus-16, confirming the diagnosis of cutaneous metastasis from his previously diagnosed human papillomavirus–related tonsil SCC. Additional imaging studies found metastases to internal organs including the brain, and he was started on chemotherapy, immunotherapy, and radiation therapy. Cutaneous metastases from tonsil SCC are exceedingly rare, and only 5 cases have been described. Furthermore, this is the first case confirming the presence of high-risk human papillomavirus by molecular studies within the cutaneous metastases. The presented case underscores the importance of recognizing this unusual manifestation of tonsil SCC metastatic to the skin along with a good clinical patient history, ensuring accurate and prompt diagnosis and treatment of this condition.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Metastatic Tonsil Squamous Cell Carcinoma: An Important Consideration in the Differential Diagnosis of Malignant Basaloid Neoplasms in the Skin: Case Report and Review of the Literature

Thigpen,

Johnston,

Giubellino

et al. 2024

The American Journal of Dermatopathology

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“…3,16 To our knowledge, only six cases of cutaneous metastasis of tonsillar origin have been individually documented (Table 1). 6,[17][18][19][20][21] The cutaneous presentation was variable, including skin swelling, confluent erythematous papules, and plaques on the face, neck, and proximal chest. Of the previously published cases, all were male (aged 34-70), with histopathologic diagnoses of tonsillar SCC and cutaneous metastasis.…”

Section: Discussionmentioning

confidence: 99%

“…Two of the patients were successfully treated. 6,19 Three of the patients received palliative therapy, 17,18,21 one of whom had advanced disease and passed away 3 months after completion of therapy. 17 The remaining patient presented with poor baseline status and advanced metastatic burden, and passed away shortly after diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…5 When present, head and neck SCC metastasis to skin generally portends a poor prognosis. 5,6 HPVpositive oropharyngeal SCC has been recognized as a distinct disease entity from its HPV-negative counterpart, and is associated with better prognosis. 7,8 While both entities carry a similar rate of distant metastasis, HPV-positive oropharyngeal SCC has shown atypical metastatic patterns and is more probable to involve unusual sites.…”

Section: Introductionmentioning

confidence: 99%

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Epidermotropic metastasis of squamous cell carcinoma of the tonsil: A case report with molecular confirmation

Barbieri

Walther

et al. 2021

J Cutan Pathol

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Metastasis of oropharyngeal squamous cell carcinoma (SCC) to skin is uncommon and portends a poor prognosis. Clinical history and histopathology are key to discerning between metastatic disease vs de novo SCC of the skin. We describe a case of an HPV+ tonsillar SCC in a 77-year-old male, with metastasis to the neck skin. This case is unique because of prominent in situ epidermal involvement on skin biopsy specimen, complicating the distinction between primary and secondary disease. The nature of the lesion was resolved using next-generation sequencing of both the primary oropharyngeal SCC and skin lesion biopsy specimens. Both tumors showed identical ATR D1639G somatic mutations, while the skin lesion contained an additional POLE F1366L mutation. Clonal evolution of metastatic lesions is a welldescribed phenomenon; comparing the genetic profiles of primary and metastatic specimens can be useful in evaluating the tumor origin as well as identifying targetable genetic aberrations.

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Cutaneous metastasis of tonsillar carcinoma: Report of a rare case

Cited by 2 publications

References 8 publications

Metastatic Tonsil Squamous Cell Carcinoma: An Important Consideration in the Differential Diagnosis of Malignant Basaloid Neoplasms in the Skin: Case Report and Review of the Literature

Metastatic Tonsil Squamous Cell Carcinoma: An Important Consideration in the Differential Diagnosis of Malignant Basaloid Neoplasms in the Skin: Case Report and Review of the Literature

Epidermotropic metastasis of squamous cell carcinoma of the tonsil: A case report with molecular confirmation

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